Implementing a New Doctrine for Health Facility Commissioning

Abstract

The experiences of hospital facility managers and consideration of the existing doctrines for commissioning building facilities have prompted the development of a new commissioning doctrine specifically conceived for health facilities by a special committee of the American Society for Healthcare Engineering. The new Health Facility Commissioning Guidelines present a doctrine calling for various tasks in the commissioning process from planning through hand-off to the health facility’s operations and maintenance staff. Facets of this new doctrine are explained, differentiating it from existing doctrines that might otherwise be relied upon. The organizational implications of adopting this doctrine for the delivery of health facilities are intended to bring efficiency to the project delivery system and enhance the communication among different stakeholders. A project that is piloting this new commissioning doctrine is described, and lessons learned through the early stages of this project draw attention to the real challenges and practical solutions devised to address them. Student interns are being employed in the task of documenting and analyzing this pilot implementation. Their major findings illustrate the needs for future study. BACKGROUND Hospitals are mission critical facilities designed to operation on a non-stop schedule to provide care for client occupants whose physical and mental well being are compromised by the onset of various forms of illness. Therefore, healthcare providers have more strict requirements for the performance of the built environment in the function of their various unique systems, e.g. heating, air, medical gas system, tubing system, etc. Notwithstanding, higher compliance standards are implemented in healthcare facilities when it comes to fire protection and their requirements for redundancy of life-critical operating systems. Based on 2011 results of an annual survey by Health Facilities Management (HFM) and the American Society for Healthcare Engineering (ASHE), most of the nation’s largest healthcare facilities are under renovation (Carpenter, 2011). Infection control, vibration, noise and dust due to construction activity are considered as the major concerns for renovation projects in healthcare facilities. In an effort to optimize performance of healthcare facilities to meet future challenges, ASHE published their